<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('No')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-no" data-source="card/index" data-params='{"custom[status]":"0", "custom[agent_id]":"0"}' data-multiple="true" class="form-control selectpage" name="row[no]" type="text" data-field="no" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('开始卡号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-start"  class="form-control" name="row[start]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('结束卡号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-end"  class="form-control" name="row[end]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('代理ID')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-agent_id" class="form-control" name="row[agent_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
